More detailed investigation, and help from Boots staff, has highlighted that its attempts to explain the loss, were just not plausible.

In the Telegraph article Boots was quoted as saying that the incident:

“…most likely occurred after documents called dispensing tokens were misfiled or accidentally shredded by a member of staff. The situation involved prescription tokens…”

(My emphases)

It later goes on to confirm that the tokens were:

“…. from the electronic prescription system which can simply be printed again“

Who re-printed the tokens?

The article mentions 2 kinds of tokens

Dispensing – printed off by the pharmacist, Boots

Prescription – printed by the GP surgery and handed to Boots for fulfillment.

Yes, the tokens can just be printed off, but Boots would needed to have applied to the various local GPs to obtain copies of the prescription tokens.

It’s not clear how the “loss” was explained to those practices.

“Misfiling” claim – the tokens were lost long before any filing takes place.

Boots Chaddesden process about 400 prescriptions/tokens per day

They are split between those that can be completed from on-site stock, and those where off-site stock needs to be ordered from the Boots Hub.

Those requiring off-site stock are ordered electronically with various checks between the token and the system to ensure accuracy. The tokens are kept, in the store, as a bundle

When the medication is delivered there is a further cross-check.

It is prior to this stage that the tokens were lost, as it is accepted that no medication had been dispensed.

The customer comes to collect their prescription:

They pay, or tick an exemption

The repeat section of the token is torn off.

Customer signs the token for receipt.

At this stage the token is physically smaller, and marked up.

With the exception of those claiming an age exemption, all signed/completed tokens are boxed up in a specific way, and sent to the NHS for audit purposes, which confirms payment to Boots. This has to be done by the 5th of the month following the month that the medication was dispensed.

Essentially, there are 2 piles, in the store, that grow as the month progresses:

Tokens to be sent off to the NHS

Tokens that are not required by the NHS – to be destroyed later.

There are no long term patient/customer files – the actual prescriptions are stored electronically.

In the unlikely event of an unfulfilled token finding its way into either of these 2 piles then they would be very easy to find…as they would look very different.

“Shredded” – there is no shredder.

The vast majority of tokens are sent to the NHS as part of the payment validation process.

The only documents that are not sent to the NHS are:

Tokens, unpaid, due to age exemption

Spoilt documents – e.g. printer failures etc.

The documents are put in a blue bag, and periodically sent for confidential disposal ( incineration)

There is no shredder in the Chaddesden branch.

Comment

Based on the detail of the process, it is implausible that the lost documents would have been misfiled – there was nowhere to misfile them to. They were certainly not shredded. If, as Boots claim, they never left the store, then a brief search would have definitely located them.

The Chaddesden branch store processes around 400 prescriptions/tokens per day. The 47 that Boots maintain that were lost ( not a much higher number reported by staff) – represent about an hour’s worth of prescriptions. The control of paperwork in the store has to be tight in order to ensure payment by the NHS. The most likely answer is, the original assumption, that they were lost…and left the store.

The Derby Telegraph article ( which was most likely drafted by Boots) is littered with statements and quotes that make no sense at all, and, in many cases, are simply illogical.

Boots are clearly working on the premise that no one will ask detailed questions, and feel that glossing over inconsistencies is a legitimate practice on such an important issue.